Effect of Combined Intravenous-Inhalational Anesthesia (CIVIA) on Postoperative Recovery Patterns.

This study was planned as a single-center, prospective, randomized trial. Adult patients undergoing elective spinal surgery lasting longer than three hours, performed in a neurosurgery operating room, will be evaluated. Patients managed with three different anesthesia methods currently used will be examined for recovery patterns: 1. Total intravenous anesthesia (TIVA), 2. TIVA Combined anesthesia with sevoflurane and intravenous agents (sevoflurane-CIVIA), 3. TIVA Combined anesthesia with desflurane and intravenous agents (desflurane-CIVIA). Recovery patterns include; extubation time, eye opening time, emergence agitation, postoperative nausia and vomiting and postoperative recovery unit discharge time.

Inclusion Criteria: * Scheduled for spine surgery * Expected surgery duration longer than 3 hours * Use of intraoperative neuromonitoring * BIS-guided anesthesia administered * TIVA (with TCI) as the primary anesthetic technique * Age \>18 years Exclusion Criteria: * Emergency surgeries * Patients receiving sole inhaled anesthesia (no TIVA) * Perioperative dural injury * Intraoperative severe hypotension requiring inotropic support * Hypothermia (based on temperature measured before recovery)